DIABETES  MELLITUS 

A  SYSTEM  OF  DIETS 


HERMAN  O.  MOSENTH. 


PAUL  B.  HOEBER,  PUBLISHER 


Columbia  Uniuersitp  '  3  2-1 
intijeCitpof  Jietogorfe 

College  of  pfjpstcianfi  ano  burgeons 


Reference  ?tttirarj> 


j:;iii      I 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/diabetesmellitusOOmose 


4 


DIABETES  MELLITUS 

A  SYSTEM  OF  DIETS 


NOTE 

The    various   diet   tables   given   in    this    book    may    be 
obtained  in  pad  form,  50  sheets  to  the  pad,  as  follows: 

Xo.  1 — Starch-Free  Diet,  Qualitative  List,   (page  11.) 
Xo.  2 — Minimal  Fat,  Starch-Free,  Measured  Diet,   (pages  1&-17.) 
Xo.  3 — Minimal  Fat,  Starch-Free,  Weighed  Diet,   (pages  22—23.) 
Xo.  4 — Low  Fat.  Starch-Free,  Measured  Diet,  (pages  1S-19.) 
Xo.  o — Low  Fat,  Starch-Free,  Weighed  Diet,   (pages  26-27.) 
Xo.  6- — Accessor}-  Diet,  Rich  in  Carbohydrates,  (page  29.) 

Per  set  of  6  pads,  So. 00;  single  pads,  SI. 00. 

Special  prices  on  large  quantities  quoted  on  application. 


PAUL  B.  HOEBER,  Publisher,  67-69  East  59th  Street,  New  York  City 


DIABETES    MELLITUS 


A    SYSTEM    OF    DIETS 


HERMAN   O.    MOSENTHAL,    M.D. 

Assistant  Professor  of  Medicine  and  Attending  Physician, 
New    York   Post-Graduate    Hospital    and    Medical    School 


NEW     YORK 
PAUL    B.    HOEBER 

67-69  East  59th  Street,  New  York 


Copyright,  1921 
By  PAXIL  B.  HOEBER 


Published  January,  1921 


Printed  in  the  United  States  of  America 


IS; 


PREFACE 

The  art  of  prescribing  diets  in  diabetes  mellitus  has  distinctly  outstripped  the 
ability  of  the  patient  or  average  nurse  to  meet  the  situation.  The  result  has  been 
that  only  the  minority  of  diabetics,  favored  by  dietitians  or  a  specially  trained 
member  of  the  household  can  indulge  in  varied  and  accurate  diets  measured  in 
grams  of  proteins,  fats  and  carbohydrates.  In  many  hospitals  the  same  condi- 
tion holds  true;  those  having  large  resources  have  a  sufficient  number  of  dietitians 
to  carry  out  the  dietetic  prescriptions  properly  while  the  majority  rely  on  a  few, 
usually  very  inadequate,  food  lists  to  meet  the  needs  of  the  patient.  The  present 
system  of  diets  has  been  designed  with  the  object  of  allowing  any  patient  or  nurse, 
without  special  training  in  dietetics,  to  carry  out  the  proper  rationing  for  cases  of 
diabetes  mellitus.  These  diet  lists  have  been  in  successful  use  in  a  number  of  hos- 
pitals and  clinics  for  several  years.  It  is  proposed  to  issue  the  individual  lists  in 
pad  form,  so  that  they  may  be  of  more  general  use.  The  plan  upon  which  these 
diets  depend  was  first  published  in  the  Medical  Clinics  of  North  America;  subse- 
quently the  scheme  for  the  "Measured  diets"  was  printed  in  The  American  Journal 
of  Medical  Sciences  by  Herbert  Wiener  and  the  author. 


TABLE  OF  CONTENTS 

Page 

Comment  on  the  Diets 9 

Diet  Lists: 

Starch-free  diet,  qualitative  list 11 

Measured  diets: 

1 .  Minimal  fat,  starch-free  diet 16 

2.  Low  fat,  starch-free  diet 18 

Weighed  diets: 

1.  Minimal  fat,  starch-free  diet. 22 

2.  Low  fat,  starch-free  diet 26 

Accessory  diet,  foods  rich  in  carbohydrates 29 

Discussion  of  Diets: 

Starch  free  diet,  qualitative  list :- 10 

Starvation 13 

Measured  diets      ' 14 

Weighed  diets 20 

1.  Minimal  fat,  starch-free  diet 20 

2.  Low  fat,  starch-free  diet 24 

Accessory  diet,  foods  rich  in  carbohydrates 28 


COMMENT  ON  THE  DIETS 

THE  diet  lists  virtually  explain  themselves.     Variety  in  the  weighed  or  measured 
diets  is  obtained  by  resorting  to  the  vegetable  or  meat  and  fish  lists.     If  finer 
gradations  than  250  calories  are  desired  in  increasing  or  diminishing  the  food 
this  can  easily  be  done  by  adding  or  taking  away  only  a  fraction  of  the  foods  by  which 
the  diet  in  use  differs  from  the  next  higher  or  lower  one. 

A  word  of  explanation  as  to  the  reason  for  the  particular  proportion  of  proteins  and 
fats  employed  and  as  to  the  method  of  prescribing  the  diets  may  be  of  some  value. 

The  minimal  fat  diets  are  intended  to  be  emergency  diets  only.  They  are  to  be 
used  when  acidosis  is  to  be  combated.  The  most  efficient  means  at  hand  to-day,  to 
prevent  the  accumulation  of  acid  substances  within  the  body,  in  diabetes  mellitus,  is  to 
cut  the  fat  intake  to  a  minimum. 

The  so-called  low  fat  diets  are  those  intended  for  prolonged  administration.  After 
some  experimentation  it  was  found  that  the  lowest  amount  of  fat,  which  serves  to  make 
the  food  palatable  in  the  long  run,  is  present  in  a  starch  free  diet  when  the  fats  and  pro- 
teins are  approximately  equal  to  each  other  gram  for  gram.  At  the  same  time  such  a 
restriction  of  fat  serves  to  keep  the  acidosis  in  check. 

It  is  realized  to-day  that  the  diabetic  can  lose  weight  without  detriment;  what  is 
not  so  generally  appreciated  is  that  this  loss  of  weight  should  occur  in  the  fat  content 
of  the  body  and  not  in  the  proteins  of  the  muscles  and  glands.  If  a  depletion  of  proteins 
takes  place  not  only  is  weight  lost,  but  strength  and  efficiency  as  well.  In  a  "Starch- 
free"  diet  the  only  form  of  food  which  has  the  ability  to  conserve  protein  are  the  proteins 
themselves;  fat  and  alcohol  appear  to  be  without  value  in  this  regard  (Mosenthal,  H.  O., 
and  Harrop,  G.  A.,  Jr.,  Arch.  Int.  Med.,  1918,  XXII,  750).  Hence  the  feeding  of  an 
excessive  quantity  of  fat  is  not  justified. 

By  clinical  observation  it  was  determined  that  small  persons  could  be  maintained 
in  a  condition  of  nitrogen  (that  is  protein)  equilibrium  on  the  present  low  fat,  starch 
free  diets  of  1500  calories,  larger  individuals  required  1750  calories  (Mosenthal,  H.  O., 
and  Clausen,  S.  W.,  Arch.  Int.  Med.,  1918,  XXI,  269).  Basing  a  mode  of  procedure 
upon  this  fact,  the  aim  has  been  to  have  the  patient  acquire  a  sugar  free  urine  while  a 
diet  of  1500  or  1750  calories  is  taken  before  starchy  food  is  added.  The  food  rich  in 
carbohydrates  may  be  subsequently  used.  The  table  giving  the  foods  in  units  of  starch 
equivalent  to  one  slice  of  bread  will  be  found  useful  in  carrying  out  this  plan. 

None  of  the  proprietary  foods  have  been  advocated  in  the  present  tables.  If  it  is 
desired  to  employ  them  it  is  wise  to  be  guided  by  the  list  of  analyses  of  diabetic  foods, 
as  furnished  by  the  Connecticut  Agricultural  Experiment  Station  at  New  Haven,  Con- 
necticut. 


STARCH-FREE  DIET 

QUALITATIVE  LIST 
Many  mild  cases  of  diabetes  mellitus  do  not  require  a  weighed  or  measured  diet 
to  maintain  a  sugar-free  urine  and  to  control  their  disease.  For  them  the  starch-free 
diet,  qualitative  list,  upon  the  opposite  page  will  suffice.  In  the  blank  space  at  the  bot- 
tom of  this  diet  sheet,  starch  containing  foods  may  be  indicated,  for  use  in  suitable  cases. 
The  list  tabulating  the  accessory  diet  of  foods  rich  in  carbohydrates  will  be  of  service 
in  this  connection. 


STARCH-FREE  DIET 

QUALITATIVE  LIST 
MAY  EAT: 

Soups — Clear  meat  broths,  which  may  contain  the  vegetables  indicated  below. 
Meats — All  kinds  of  meat,  fresh,  smoked  or  cured,  except  liver;  all  meats  must  be 

prepared  without  flour  or  bread-crumbs. 
Fish — All  kinds  of  fish,  but  no  clams,  oysters  or  scallops. 
Eggs — Eggs  in  any  form,  prepared  without  milk,  flour  or  sweetening  (sugar,  jam, 

etc.). 
Butter — Butter,  oil  and  lard. 
Cheese — All  kinds  of  cheese. 
Vegetables — Asparagus,    asparagus    tips,    brussels    sprouts,    cabbage,    cauliflower, 

celery,  cucumbers,  egg  plant,  endive,  greens  from  beets,  kohlrabi,  leeks,  lettuce, 

pickles  (sour  or  dill),  pumpkin,  radishes,  rhubarb,  sauerkraut,  sorrel,  spinach, 

string  beans,  swiss  chard,  tomatoes,  water  cress,  wax  beans. 
Desserts — Gelatine  jellies  (use  sour  white  wine,  brandy  or  coffee  for  flavoring). 
Beverages — Tea,  coffee  and  cocoa  made  from  cracked  cocoa  (cocoa  nibs),  sweetened 

with  saccharine  (without  sugar  or  milk);  claret,  burgundy,  sour  white  wine,  and 

whiskey  in  moderate  amounts;  carbonated  waters. 
Condiments — Pepper,  salt,  mustard,  oil,  vinegar,  saccharine. 

MUST  AVOID  EATING: 

Sugar  in  any  form.  Bread,  biscuits,  and  cakes  of  all  kinds.  Toast,  crackers,  rice, 
oatmeal  (and  all  cereals);  sago,  tapioca,  macaroni,  vermicelli,  potatoes,  carrots, 
parsnips,  beets,  corn,  beans,  peas.  All  fruits,  fresh,  preserved  and  dried.  Jams 
and  jellies.  Pastry,  puddings  and  ice  cream.  Sauces  and  gravies  thickened  with 
flour. 

MUST  AVOID  DRINKING: 

Milks,  ales,  porter,  stout,  beer,  cider,  all  sweet  wines,  port  wine,  liqueurs,  sparkling 
wines,  syrups. 

BESIDES  ABOVE  MUST  EAT: 


11 


STARVATION 

When  complete  abstinence  from  food  is  indicated  and  the  so-called  "starvation 
treatment"  is  employed  the  following  articles  of  food,  whose  nutritive  value  is  negligible, 
are  allowed:  Clear  broth,  black  coffee,  plain  tea,  saccharine,  salt  and  pepper.  In  some 
instances  the  use  of  alcohol  is  permissible.  Alcohol  does  not  increase  the  production 
of  sugar ;  it  has  a  tendency  to  further  the  oxidation  of  the  acid  substances  along  normal 
channels,  thus  diminishing  acidosis,  and  it  has  an  appreciable  food  value.  These  facts 
point  to  alcohol  as  an  ideal  food  for  the  diabetic.  However,  its  use  has  been  largely  dis- 
continued, especially  during  starvation,  as  there  are  many  patients  in  whom  the  alcohol 
is  prone  to  disagree  and  cause  nausea  and  vomiting.  When  it  is  desired  to  use  alcohol, 
whiskey,  brandy,  claret  or  sour  white  wine  may  be  ordered. 

There  is  one  point  well  worth  bearing  in  mind  in  administering  the  starvation  treat- 
ment. This  is  the  fact  that  under  this  form  of  diet  the  patient  frequently  loses  a  great 
deal  of  water  from  the  tissues.  This  results  in  a  feeling  of  weakness  and  lassitude  which 
often  is  very  marked  and  in  advanced  cases  of  diabetes  may  assume  a  serious  aspect- 
Such  a  loss  of  fluid  from  the  body  may  be  prevented  by  the  administration  of  considerable 
amounts  of  salt  in  the  broth  or  the  use  of  bicarbonate  of  soda.  If  a  slight  degree  of  edema 
ensues  it  does  no  harm  though  it  should  not  be  allowed  to  reach  undue  proportions. 


THE  MEASURED  DIETS 

The  following  lists  have  been  prepared  in  order  to  bring  weighed  diets  to  their 
simplest  possible  terms.  They  have  been  designed  especially  for  diabetic  patients  who 
are  able  to  be  up  and  about  attending  to  their  routine  duties,  and  not  endowed  with 
unlimited  means.  The  successful  management  of  such  patients  depends  largely  upon 
the  ease  with  which  they  are  enabled  to  follow  the  prescribed  dietary  regime.  By  the 
use  of  these  diet  lists  the  physician  can  readily  control  the  total  caloric  intake  as  well  as 
the  relative  amounts  of  proteirj ,  fat  and  carbohydrate  consumed,  while  at  the  same  time 
the  essential  cooperation  of  the  patient  is  reduced  to  a  minimum  in  time  and  mental  effort. 

The  measured  diets  in  the  modern  treatment  of  diabetes  must  meet  two  require- 
ments: (1)  Control  of  the  glycosuria,  and  (2)  control  of  the  acidosis.  The  first  of  these 
is  accomplished  by  regulating  the  consumption  of  the  carbohydrates  and  proteins,  and  the 
second  by  adjusting  the  fat  intake.  The  greatest  recent  advance  in  the  management  of 
diabetes  melhtus  is  the  recognition  of  the  fact  that  a  curtailment  of  the  fatty  foods  will 
prevent  or  postpone  acidosis  and  coma.  Two  sets  of  diets  are  necessary,  therefore:  (1)  In 
which  the  fats  are  reduced  to  a  minimum,  and  (2)  in  which  fats  are  allowed  more  fiber- 
ally,  but  in  limited  amounts.  The  latter  is  the  preferable  diet  to  use  when  possible,  as 
it  is  much  the  more  palatable  when  continued  for  a  long  time.  Accordingly,  two  diets 
have  been  designed,  one  the  so-called  "minimal  fat  diet"  and  the  other  the  "low  fat 
diet;"  in  both  of  them  the  only  carbohydrate  is  that  contained  in  the  green  vegetables. 

The  minimal  fat  diet  is  graded  by  250  calory  steps  from  500  to  1250  calories.  It  is 
not  feasible  to  increase  the  diet  beyond  this  point,  because  when  proteins  make  up  the 
greater  part  of  the  nourishment,  as  they  necessarily  do  in  the  minimal  fat  diet,  the  bulk 
of  food  becomes  too  great.  It  is  even  problematical  whether  all  patients  can  consume 
the  amounts  designated  under  the  1250  calory  diet.  However,  the  safest  way  to  curtail 
the  food  in  diabetics  suffering  with  severe  acidosis  or  threatened  coma  is  first  to  restrict 
the  fats.  By  means  of  the  present  list,  this  can  easily  be  done.  Carbohydrates  may  be 
added  if  it  is  thought  advisable. 

For  practical  purposes  of  rough  measurement  the  table  and  teaspoonful  portions 
are  adequate  and  exact  within  a  reasonable  margin  of  error.  The  portions  of  meat  and 
fish  are  calculated  to  within  the  nearest  3^-ounce  value.  One-quarter  ounce  is  probably 
closer  than  the  average  scales  of  the  butcher  or  home  can  weigh  accurately,  but  in  giving 
the  amounts  in  these  fractions  an  indication  is  furnished  on  what  side  allowances  should 
be  made.     The  actual  use  of  these  diet  lists  is  self-explanatory. 

A  concrete  idea  of  the  proportion  of  proteins  and  fats  in  these  diets  may  be  gained 
from  the  following  tables.  In  the  minimal  fat  diet  the  ratio  of  protein  to  fat  is  found 
to  be  about  3  to  1  when  round  steak  is  eaten  as  the  meat  or  fish,  and  17  to  1  when  blue 
fish  is  used.  This,  in  either  case,  furnishes  a  very  low  fat  intake.  When  the  lowest 
possible  quantity  of  fat  is  required  it  is  evident  that  fish  is  more  desirable  than  meat. 

14 


MEASURED  DIETS 


Approximate  Quantities  of  Protein,  Fat  and  Carbohydrate  in  the  Minimal  Fat,  Starch- 
free  Diet  when  Round  Steak  or  Blue  Fish  are  Used  as  Meat  or  Fish 


Minimal  fat  diet  whe 


500  calories. 

750  calories. 
1000  calories . 
1250  calories. 


126 
159 


Minimal  fat  diet  ' 
used: 

500  calories .  . . 

750  calories . .  . 
1000  calories.. 
1250  calories.  .  . 


Fat,    Carbohydrate, 


148 
193 

244 


The  next  table  gives  the  relative  values  of  protein,  fat  and  carbohydrate  when 
roast  beef,  round  steak  or  flounder  are  used  as  the  meat  or  fish  in  the  low  fat  diet.  These 
particular  foods  were  selected  because  they  represent  a  high,  average  and  low  fat  con- 
tent for  these  diets.  When  roast  beef  is  eaten  the  fat  is  higher  than  the  protein;  with 
the  flounder  the  ratio  is  reversed.  The  low  fat  diet,  when  the  patient  chooses  his  own 
food,  has  been  calculated  and  found  to  contain,  as  a  rule,  proteins  and  fats  approxi- 
mately equal  gram  for  gram. 

Approximate  Quantities  of  Protein,  Fat  and  Carbohydrate  in  the  Low  Fat,  Starch-free 
Diet  when  Roast  Beef,  Steak  or  Flounder  are  Used  as  Meat  or  Fish 


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22 

39 

12 

500  calories 

44 

29 

12 

500  calories 

73 

16 

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750  c 

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33 

71 

12 

750  calories 

72 

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750  calories 

122 

22 

12 

1000  c 

alories 

39 

83 

15 

1000  calories 

87 

64 

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1000  calories 

149 

37 

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1250  c 

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106 

17 

1250  calories 

105 

83 

17 

1250  calories 

172 

52 

17 

1500  c 

alories 

66 

126 

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1500  calories 

134 

97 

18 

1500  calories 

217 

59 

18 

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alories 

75 

149 

19 

1750  calories 

147 

118 

19 

1750  calories 

235 

77 

19 

2000  c 

aIories 

85 

169 

19 

2000  calories 

164 

136 

19 

2000  calories 

259 

92 

19 

In  the  low  fat  diets  there  is  no  difficulty,  as  far  as  bulk  of  food  is  concerned,  in  con- 
suming as  much  as  2000  calories.  As  Mosenthal  and  Clausen  have  shown  a  carbohy- 
drate-free diet  of  1500  to  1750  calories,  containing  approximately  the  same  proportion  of 
protein  and  fat  as  the  present  list,  will  maintain  the  nitrogen  equilibrium  of  the  diabetic 
and  may  be  considered  to  furnish  the  patient  with  enough  food  to  make  him  mentally  and 
physically  efficient.  If  the  carbohydrate  tolerance  of  the  patient  permits  of  a  still  further 
increase  in  the  food  it  is  best  to  add  starch-containing  foods  and  not  proteins  or  fats. 

The  above  food  lists  are  presented  in  the  belief  that  they  will  furnish  a  practical  means 
of  regulating  the  diet  of  sufferers  from  diabetes  mellitus  who  are  not  receiving  hospital 
treatment,  and  who,  while  under  medical  supervision,  are  dependent  upon  their  own 
resources  for  the  details  of  dietetic  control.  These  diets  are  not  intended  in  any  way  to 
supplant  the  more  accurate  and  ideal  means  of  weighing  and  measuring  food,  as  are 
detailed  in  the  subsequent  diets,  the  weighed  diets. 

As  printed  on  the  following  pages,  the  diets  and  their  supplementary  lists  are  printed 
face  to  face.  In  pad  form  they  are  printed  back  to  back,  so  that  one  sheet  furnishes  a 
complete  dietary  scheme. 

15 


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MINIMAL  FAT  STARCH-FREE  DIET— MEASURED  DIET 


Meat  and  Fish  Portions 


i  of  food  weighed  : 


Portion 


MEATS 

Beef: 

Soup  meat,  fore-shank,  lean. . . 

Dried  beef 

Lean  round  steak 

Lean  roast  beef  (no  visible  fat) 

Kidney 

Chicken 

Lean  leg  of  lamb  (no  visible  fat) . 

Tripe 

Lean  veal  (no  visible  fat) 


FISH  (Fresh  only) : 

Bluefish '. 

Codfish 

Flounder 

Haddock 

Sea  Bass 

Sheepshead 

Smelts 

Weakfish 


A 

B 

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D 

3 

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3M 

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3M 

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3 

4M 

7H 

9 

1% 

2K 

4 

5 

5% 

m 

14 

16% 

2% 

4 

7 

8 

4 

6 

m. 

11% 

4H 

6K 

11 

13 

5M 

SH 

14 

16H 

m 

7 

im 

UK 

4^ 

GK 

ioH 

12M 

3 

4M 

7K 

9 

4 

6 

10 

11% 

3% 

5M 

9% 

11 

E 

11% 
6% 
9^ 
9% 

12 

12 
6% 

22 

11 


ISM 

17M 

22 

19 

16K 
12 

15M 
14% 


Vegetables 
{Fresh  or  Canned) 


Asparagus 

Asparagus  tips 

Brussels  sprouts 

Cabbage 

Cauliflower 

Celery 

Cucumbers 

Egg  plant 

Endive 

Greens  from  beets 

Kohlrabi 

Leeks 

Lettuce 

Pickles,  sour  or  dill 

Pumpkin 

Radishes 

Rhubarb 

Sauerkraut 

Sorrel 

Spinach 

String  beans 

Swiss  chard 

Tomatoes 

Water  cress 

Wax  beans 


17 


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18 


LOW  FAT,  STARCH-FREE    DIET— MEASURED    DIET 


Meat  axd  Fish  Portions 


Ounces  of  food  weighed  i 


MEATS  Portion 

Bacon,  fried,  fat  thrown  away 

Brain 

Chicken  (to  be  boiled  or  broiled) 

Chicken  (to  be  roasted) 

Corned  beef -. 

Dried  beef 

Duck 

Ham,  smoked  (to  be  boiled  or  broiled) 

Guinea  hen 

Kidney 

Lamb  chops 

Lamb  (to  be  roasted) 

Mutton  (to  be  boiled) 

Mutton  chops,  lean 

Mutton  (to  be  roasted) 

Pork  (to  be  roasted) 

Pork  chop,  lean  (to  be  broiled) 

Roast  beef 

Soup  meat,  fore-shank,  lean  (to  be  boiled)  - 

Squab 

Steak,  round,  lean 

Steak,  sirloin,  lean 

Tongue,  fresh  (to  be  boiled) 

Tongue,  boiled,  smoked,  cold 

Veal,  roast  or  chop,  lean 


FISH,  fresh 

(To  be  boiled  or  broiled) 

Bass,  black 

Bass,  sea 

Bluefish 

Butterfish 

Codfish 

Flounder 

Haddock 

Halibut 

Kingfish 

Mackerel 

Perch 

Pike 

Porgy 

Salmon 


Portion 


Smelts 

Weakfish 

Whitefish 

Canned  or  Smoked 

Herring,  smoked 

Salmon,  canned 

Sardines  in  oil 

Sturgeon,  smoked 

Tunnyfish  in  oil,  canned . 


A 

1M 
2K 

2Y2 

iK 

1 

IK 

1M 

1 

2 

2K 

0 

1 

1M 
2M 

1 

1.4 

2 

0 

2K 

1'2 

2 

m 
m 
1 

2M 


A 

3 

3K 

3K 

m 

3K 

m 

4 

2K 

3K 

2 

34 

3% 

2K 

m 

2M 
3K 
3 
4 

1 
IK 

1 

m 

1 


B 

C 

IK 

2% 

3 

3K 

3 

5K 

IVi 

m 

IK 

2K 

IK 

3 

IK 

2H 

IK 

2K 

2K 

4K 

3 

5K. 

1 

IX 

IK 

2K 

2 

4 

2K 

1% 

1 

2 

m 

3 

2K 

4 

1 

w 

3 

3.K 

m 

3 

2K 

4M 

2 

3M 

m 

4 

1 

2 

2K 

4H 

D 

3 

6 

6 

2M 

2K 

ZM 

m 

2H 

4K 

6 

2 

2K 

4Ji 

5K 

2K 

SK 

4Ji 

2 

6 

3M 

4M 

4 

4K 

2K 

■5K 


B 

c 

3K 

6K 

4M 

7X 

4 

7K 

2 

3K 

4K 

8 

5K 

10K 

4% 

8H 

2?4 

5K 

4 

7K 

2M 

4K 

±K 

7K 

m 

8 

m 

5K 

IX 

3 

3 

5K 

4 

7K 

3K 

6K 

4M 

8K 

IK 

2K 

IK 

3K 

IK 

2K 

IK 

3 

IK 

2K 

D 


8K 
7X 
4 

8K 
11 
9K 
5K 
8 
5 

8K 
8M 
5K 
3K 
6 
S 

7K 
9K 

2K 
3K 
2K 

3K 
2U 


E 

3K 

7K 

7K 

3K 

2K 

4K 

3K 

3 

5K 

7K 

2K 

3 

5K 

6K 

2K 

4K 

5K 

2K 

7K 

4K 

5X 

5 

5K 

2K 

6K 


E 

9 
10K 

9M 

5 
11 
14 
12 

7K 
10 

6K 

10K 

11 
7K 
4K 
7K 

10 
9K 

12 

3 

4K 

3 

4 

3 


F 
5 
94 

10 
4K 
3K 
SK 
4K 
4 
7K 

10 
3K 
4 
7 

8K 
3K 
5K 
7 

3K 
9K 
5K 
7K 
6K 
7 

3K 
8K 


F 

UK 

13'  o 

12K 
6K 
14 

IS 

15K 

9K 

13 
8 

13K 

14 
9K 
5K 
9K 

13 

12 

15K 

3K 
5K 
4 
5K 

4 


Vegetables 
(Fresh  or  Canned) 


Asparagus 

Asparagus  tips 

Brussels  sprouts 

Cabbage 

Cauliflower 

Celery 

Cucumbers 

Egg  plant 

Endive 

Greens  from  beets 

Kohlrabi 

Leeks 

Lettuce 

Pickles,  sour  or  dill 

Pumpkin 

Radishes 

Rhubarb 

Sauerkraut 

Sorrel 

Spinach 

String  beans 

Swiss  chard 

Tomatoes 

Water  cress 

Wax  beans 


THE  WEIGHED  DIETS 

These  diets  may  be  employed  when  the  means  are  at  hand  to  weigh  the  food  with 
some  accuracy.  They  are  preferable  to  the  measured  diets.  The  patient  or  intelligent 
attendant  can  learn  to  use  these  lists  in  a  very  short  time  and  provide  menus  which  pre- 
sent a  considerable  variety,  please  the  patient's  taste,  as  far  as  this  is  possible  on  a  starch- 
free  diet,  and  are  adapted  to  the  needs  of  the  sufferer  with  diabetes  mellitus. 


MINIMAL  FAT,  STARCH-FREE  DIET,  WEIGHED  DIET 

This  set  of  diets  is  intended  for  use  in  those  emergencies  when  the  lowest  possible 
amount  of  fat  is  to  be  administered  so  as  to  control  acidosis.  When  the  means  of  weigh- 
ing the  food  are  not  at  hand  the  minimal  fat,  starch-free  measured  diet  may  be  resorted 
to.  These  diets  are  not  intended  for  long  continued  use.  On  account  of  the  bulky 
character  of  the  proteins,  which  make  up  the  greater  part  of  the  ration,  it  is  not  feasible 
to  raise  these  diets  above  1250  grams. 

A  summary  of  the  food  values  is  as  follows: 


Minimal  Fat,  Starch-free  Diet,  Weighed  Diet 
Summary  of  Food  Values 


750 


Protein,  gm 

Fat,  gm 

Carbohydrate,  gm 
Actual  calories. .  .  . 


33 
6 

15 
253 


67 

15 

18 

494 


111 
24 
19 

556 


145 

34 

23 

1002 


183 
43 
26 

1257 


If  meat  or  fish  containing  less  fat  and  more  protein  than  the  round  steak  be  substi- 
tuted, the  fat  content  of  these  diets  may  be  lowered  still  further. 

The  individual  food  values  for  some  of  these  diets  are  given  in  the  subsequent  tables. 
A  reference  to  these  figures  will  enable  the  physician  or  dietitian  to  make  finer  gradations 
or  other  modifications  in  these  diets  without  recourse  to  more  elaborate  tables  for  food 
values. 

20 


WEIGHED  DIET 

MINIMAL  FAT,  STARCH-FREE  DIET,  WEIGHED  DIET 
500  calories 


Breakfast: 

Steak,*  round,  lean,  gm. 
Vegetables  from  list,  gm 
Black  coffee  or  plain  tea 

Dinner: 

Clear  meat  broth,  cc. . . . 
Steak,*  round,  lean,  gm. 
Vegetables  from  list,  gm 
Black  coffee  or  plain  tea 

Supper: 

Clear  meat  broth,  cc. . . . 
Steak,*  round,  lean  gm. 
Vegetables  from  list,  gm 
Black  coffee  or  plain  tea 


60 

200 


200 

70 

200 


200 

60 

200 


16.6 
2.0 


4.4 

19.3 

2.0 


4.4 
16.6 
2.0 


4.6 
0 


0.4 
5.4 
0 


0.4 
4.6 
0 


0 
6.0 


0 
0 
6.0 


0 
0 
6.0 


111 
33 


22 

129 
33 


22 

111 
33 


15.4 


18.0 


MINIMAL  FAT,  STARCH-FREE  DIET,  WEIGHED  DIET 
1000  calories 


Breakfast: 

Steak,*  round,  lean,  gm 

Vegetables  from  list,  gm 

Black  coffee  or  plain  tea 

Dinner: 

Clear  meat  broth,  cc ■ 

Steak,*  round,  lean,  gm 

Vegetables  from  list,  gm 

Pot  cheese,  gm 

Gelatin  jelly  flavored  with  coffee  and  sac- 
charine, gm 

Black  coffee  or  plain  tea 

Supper: 

Clear  meat  broth,  cc 

Steak,  *  round,  lean,  gm 

Vegetables  from  list,  gm 

Black  coffee  or  plain  tea 


120 

200 


200 

150 

250 

40 


200 
150 
250 


33.1 

2.0 


9.2 

0 


0.4 
11.6 
0 
0.4 


0 
6.0 


4.4 

41.4 

2.5 


0 


0.4 
11.6 

0 


0 
0 
7.5 


221 
33 


22 

278 

41 

45 


22 

278 

41 


144.7 


33.6 


*  Other  meats  and  fish  may  be  substituted  for  the  round  steak  according  to  their  caloric  equivalents  from  the 
accompanying  list. 

On  the  next  two  pages  the  figures  for  the  minimal  fat,  starch-free,  weighed  diets  as 
they  are  to  be  used  are  given.  In  pad  form,  the  two  pages  which  face  each  other  are 
printed  back  to  back,  so  that  one  sheet  furnishes  a  complete  dietary  scheme. 

21 


MINIM-AX  FAT,  STARCH-FREE  DIET,  WEIGHED  DIET 


BREAKFAST— Steak,*  round,  lean,  gm. 

Vegetables  from  list,  gm 

Black  coffee  or  plain  tea  as  desired. . 


DINNER— Clear  meat  broth,  cc 

Steak,*  round,  lean,  gm 

Vegetables  from  list,  gm 

Pot  cheese,  gm 

Gelatin  jelly  flavored  with  coffee  and  saccharine,  gm . 
Black  coffee  or  plain  tea  as  desired 


20 

60 

100 

120 

100 

200 

200 

200 

200 

200 

200 

200 

30 

70 

100 

150 

200 

200 

200 

250 

30 

40 

60 

70 

160 


250 
180 
300 

50 

70 


SUPPER— Clear  meat  broth,  cc 

Steak,*  round,  lean,  gm 

Vegetables  from  list,  gm 

Black  coffee  or  plain  tea  as  desired 


SPECIAL  ORDERS— 

Saccharine  as  desired. 


200 

200 

200 

200 

20 

60 

100 

150 

200 

200 

200 

250 

250 
200 
300 


*  Other  meats  and  fish  may  be  substituted  for  the  round  steak  according  to  their  caloric  equivalents  from 
the  accompanying  list. 


2-2 


MINIMAL  FAT,  STARCH-FREE  DIET— WEIGHED  DIET 


Caloric  Equivalent  of  10  Gm.  of  Lean  Round  Steak  in  Meat  or  Fish 


MEATS : 

Round  steak,  lean 

Chicken 

Dried  beef 

Guinea  Hen 

Kidney 

Mutton  chop,  lean 

Mutton,  boiled,  lean. .  .  . 
Roast  beef,  very  lean. . . 

Steak,  round,  lean 

Sweet  breads 

Veal,  roast  or  chop,  lean 

FISH: 

Bass,  black 

Bass,  sea 

Bluefish 

Codfish 

Flounder 

Haddock 

Halibut 

Perch 

Pike 

Porgy 

Shad  Roe 

Smelts 

Trout 

Weakfish 

Whitefish 

FISH,  PRESERVED: 

Cod,  salt 


Protein, 

Fat, 

gm. 

gm. 

10 

2.8 

0.8 

11 

3.5 

0.5 

9 

3.5 

0.5 

12 

2.8 

0.8 

17 

2.8 

0.8 

14 

3.2 

0.6 

11 

3.4 

0.5 

17 

4.0 

0.3 

10 

2.8 

0.8 

11 

4.4 

0.1 

14 

4.0 

0.2 

19 

3.9  - 

0.3 

2.3 

4.6 

0.1 

13 

3.4 

0.6 

19 

4.1 

0.1 

30 

4.3 

0.2 

19 

4.2 

0.1 

15 

3.1 

0.6 

17 

3.3 

0.7 

24 

4.5 

0.1 

16 

3.0 

0.8 

15 

3.1 

0.6 

22 

3.5 

0.4 

17 

3.6 

0.4 

20 

3.6 

0.5 

12 

2.7 

0.8 

17 

4.6 

0.1 

19 

19 
19 
19 
19 
19 
19 
19 
19 
19 
18 


19 
20 
20 
18 
20 
18 
18 
20 
19 
20 
18 
18 
18 
19 
19 


20 


Vegetables 
Fresh  or  Canned 


Asparagus 

Asparagus  tips 

Brussels  sprouts 

Cabbage 

Cauliflower 

Celery 

Cucumbers 

Egg  plant 

Endive 

Greens  from  beets 

Kohlrabi 

Leeks 

Lettuce 

Pickles,  sour  or  dill 

Pumpkin 

Radishes 

Rhubarb 

Sauerkraut 

Sorrel 

Spinach 

String  beans 

Swiss  chard 

Tomatoes 

Water  cress 

Wax  beans 


LOW  FAT,  STARCH-FREE  DIET— WEIGHED  DIET 

This  series  of  diets  is  intended  for  routine  use  in  those  cases  in  which: 

1.  Restriction  of  protein  is  necessary  to  control  the  glycosuria. 

2.  There  is  no  indication  to  curtail  fats  to  the  utmost  because  of  a  severe  acidosis, 
or  threatening  coma. 

3.  The  means  of  weighing  the  diet  are  at  hand;  if  this  is  not  the  case  the  low  fat, 
starch-free  diet,  measured  diet,  must  be  resorted  to. 

As  previously  stated,  it  requires  1500  calories  of  this  diet  series  to  prevent  loss  of 
protein  from  the  body  in  small  persons,  whereas  larger  individuals  require  approximately 
1750  calories  to  accomplish  this.  Foods  rich  in  carbohydrate,  according  to  the  accessory 
diet  list,  may  be  added  when  a  tolerance  for  the  diets  that  prevent  the  loss  of  protein, 
is  acquired. 

A  summary  of  the  values  for  protein,  fat,  carbohydrate  and  calories  for  these  diets 
is  as  follows: 


750 


1000 


1250 


1750 


2000 


Protein,  gm 

Fat,  gm 

Carbohydrate,  gm. 
Calories,  actual . . . 


40.4 
31.0 
12.0 
503 


59.2 
49.2 
12.0 
750 


71.2 
71.6 
12.0 
1006 


89.5 
89.6 
12.5 
1252 


99.9 
110.7 

12.5 
1489 


124.4 

128.1 

12.5 

1753 


135.7 

144.4 

21.7 

1986 


The  individual  food  values  for  some  of  these  diets  are  given.  A  reference  to  these 
figures  will  enable  the  physician  or  dietitian  to  make  finer  graduations  or  other  modifi- 
cations in  these  diets  without  recourse  to  more  elaborate  tables  for  food  values. 

500  Calories 


Food 

Gm.  or 

Protein, 
gm. 

Fat, 
gm. 

C-H, 
gm. 

Calories 

Calories 
per  meal 

Breakfast : 

50 
40 

150 

40 

200 

5 

150 

40 

200 

5 

6.6 
4.2 

3.3 

9.4 
2.0 
0.1 

3.3 
9.4 
2.0 
0.1 

6.0 
7.6 

0.3 
4.1 

0 
4.3 

0.3 

4.1 

0 
4.3 

0 
0 

0 
0 
6.0 
0 

0 

0 

6.0 

0 

83 
SS 

16 
77 
33 
40 

16 
77 
33 
40 

Dinner: 

Butter 

166 

Supper: 

166 

40.4 

31.0 

12.0 

503 

1  The  bacon  is  weighed  uncooked.     The  fat  and  protein  is  calculated  for  the  cooked  product. 

2  The  caloric  equivalent  of  other  meat  or  fish  should  be  frequently  substituted  from  the  list  on  page  27  to 
furnish  variety  in  the  diet. 

3  Two  or  three  different  vegetables  should  be  chosen  from  the  list  on  page  27  which  tabulates  the  vegetables 
containing  5  per  cent,  or  less  of  carbohydrates. 

24 


1000  CALORIES 


Breakfast: 

Eggs  (2) 

Bacon  (see  foot  note  1,  page  24). . . . 

Butter 

Black  coffee 

Dinner: 

Broth 

Steak  (see  foot  note  2,  page  24) 

Vegetables  (see  foot  note  3,  page  24) 

Olive  oil 

Butter 

Black  coffee   

Supper: 

Broth 

Steak  (see  foot  note  2,  page  24) 

Vegetables  (see  foot  note  3,  page  24) 

Butter 

Tea  (plain) 


150 
100 
200 


3.3 

17.9 
2.0 


12.0 
9.6 
4.3 


Calories 
per  meal 


1500  CALORIES 

Food 

Gm.  or 

Protein, 
gm. 

Fat, 
gm. 

C-H, 

gm. 

Calories 

Calories 
per  meal 

Breakfast: 

100 
60 
10 

150 
140 
200 
20 

15 
15 

150 
50 
100 
200 
15 

13.2 
6.4 
0.1 

3.3 
33.5 

2,0 
5.2 
0 
0.2 

3.3 
6.6 
23.9 
2.0 
0  2 

12.0 
11.5 
8.6 

0.3 
14.3 

0 

6.7 
15.0 
12.9 

0.3 
6.0 

10.2 
0 

12.9 

0 
0 
0 

0 

0 

6.0 

0.5 

0 

0 

0 

0 

0 

6.0 

0 

166 
133 
80 

16 
270 
33 
86 
140 
120 

16 
83 

193 
33 

120 

379 

Dinner: 

Olive  oil 

665 

Supper: 

Vegetables  (see  foot  note  3,  page  24) 

Butter 

445 

99.9 

110.7 

12.5 

1489 

2000  CALORIES 

Food 

Gm.  or 

Protein, 
gm. 

Fat, 
gm. 

C-H, 
gm. 

Calories 

Calories 
per  meal 

Breakfast: 

100 
75 
15 

100 

160 
160 
300 
30 
20 
15 

160 
100 
140 
300 
20 

13.2 
15.2 
0.2 
1.0 

3.5 
38.2 
3.0 
7.8 
0.2 
0 

3.5 
13.2 
33.5 
3.0 
0.2 

12.0 
16.8 
12.9 
0 

0.3 
16.3 

0 
10.1 
17.2 
15.0 

0.3 
12.0 
14.3 

0 

17.2 

0 
0 
0 
3.0 

0 

0 

9.0 

0.7 

0 

0 

0 

0 

0 

9.0 

0 

166 

219 

120 

16 

17 
308 

49 
129 
160 
140 

17 
166 
270 

49 
160 

Ham 

521 

Dinner: 

Broth 

Supper: 

Eggs  (2) 

Steaks  (see  foot  note  2,  page  24) 

Vegetables  (see  foot  note  3,  page  24) 

135.7 

144.4 

21.7 

1986 

On  the  next  two  pages  the  figures  for  the  low  fat,  starch-free,  weighed  diets  as  they 
are  to  be  used  are  given.  In  pad  form,  the  two  pages  which  face  each  other,  are  printed 
back  to  back,  so  that  one  sheet  furnishes  a  complete  dietary  scheme. 

25 


LOW  FAT,  STARCH-FREE  DIET,  WEIGHED  DIET 


BREAKFAST— Eggs,  gm. 

Bacon,*  gm 

Ham,  gm 

Butter,  gm 

Vegetables,**  gm 

Black  coffee  .  . 


DINNER— Broth,  cc... 

Steak  (Sirloin),***  gm. 

Vegetables,**  gm 

Cream  cheese,  gm 

Butter,  gm 

Olive  oil,  cc 

Black  coffee 


(1)50 
40 


(1)50 
40 


150 

40 

200 


150 

90 

200 

5 
10 


(2)100 

(2)100 

50 

60 

5 

5 

150 

150 

100 

125 

200 

200 

20 

10 

15 

10 

10 

(2)100     (2)100  (2)100 
60 

75  ■        75 

10  ,'        15 

Ml    ioo 


150 

140 

200 

20 

15 

15 


150 

160 

200 

25 

15 

15 


160 
160 
300 

30 
20 
15 


SUPPER— Broth,  cc 

Eggs,  gm 

Steak  (Sirloin),***  gm 

Vegetables,**  gm 200 

Butter,  gm 

Tea  (plain) 


150 

150 

150 

150 

150 
(1)50 

40 

70 

75 

100 

100 

200 

200 

200 

200 

200 

5 

5 

10 

10 

15 

150  j      160 

(1)50  (2)100 

140  j      140 

200  !      300 

20  20 


SPECIAL  ORDERS— 

Saccharine  as  desired. 


*  The  bacon  is  weighed  uncooked.     The  fat  and  protein  content  is  calculated  for  the  cooked  product. 
**  Two  or  three  different  vegetables  should  be  chosen  from  the  accompanying  list  which  tabulates  the  vege- 
tables containing  5  per  cent,  or  less  of  carbohydrates. 

**  The  caloric  equivalent  of  other  carbohydrate-free  meat  or  fish  should  be  frequently  substituted  from  the 
accompanying  list  to  furnish  variety  in  the  diet. 

26 


LOW-FAT,  STARCH-FREE  DIET— WEIGHED  DIET 


Caloric  Equivalent  of  10  Gm.  of  Sirloin  Steak  in  Meat  or  Fish 


Meals: 

Sirloin  steak 

Bacon,  fried,  fat  discarded 

Brains,  beef 

Capon 

Chicken 

Corned  beef 

Dried  beef. 

Duck 

Ham,  fresh 

Ham,  smoked 

Ham,  smoked,  boiled 

Ham,  smoked,  fried 

Guinea  hen 

Kidney 

Lamb  chop. 

Lamb,  roast 

Mutton  chop,  lean 

Mutton,  boiled,  lean 

Mutton,  roast 

Pork  chop,  lean 

Pork,  roast 

Roast  beef 

Roast  beef,  very  lean 

Squab 

Steak  round,  lean 

Steak  sirloin,  lean 

Steak,  tenderloin 

Sweet  breads 

Tongue  beef 

Turkey,  roast 

Veal,  roast  or  chop,  lean.  . 

Fish,  fresh: 

Bass,  black 

Bass,  sea 

Bluefish 

Butterfish 

Codfish 

Flounder 

Haddock 

Halibut 

Mackerel 

Perch 

Pike 

Porgy 

Salmon 

Shad 

Shad  roe 

Smelts 

Trout 

Weakfish 

White  fish 

Fish,  preserved: 

Cod,  salt 

Herring,  smoked 

Mackerel,  salt 

Salmon,  canned 

Sardines,  canned 


Gm. 

Protein,  gm. 

Fat,  gr 

10 

2.4 

1.0 

7 

0.9 

1.6 

16 

1.4 

1.5 

9 

2.4 

1.0 

11 

3.5 

0.5 

6 

0.9 

1.6 

9 

3.5 

0.5 

6 

1.0 

1.6 

5 

O.S 

1.7 

4 

0.7 

1.6 

7 

1.4 

1.6 

5 

1.1 

1.7 

12 

2.8 

O.S 

17 

2.8 

O.S 

5 

1.1 

1.5 

10 

2.0 

1.3 

14 

3.2 

0.0 

11 

3.4 

0.5 

6 

1.5 

1.4 

12 

3.1 

0.7 

9 

2.6 

0.9 

5 

1.1 

1.4 

17 

4.0 

0.3 

7 

1.3 

1.6 

10 

2.8 

0.8 

10 

2.4 

1  .0 

7 

1.7 

1.4 

11 

4.4 

0.1 

12 

2.3 

1.1 

7 

2.0 

1.3 

14 

4.0 

0.2 

3.9 
4.6 
3.4 
2.0 


0.7 
0.1 


3.5 

0.4 

3.6 

0.4 

3.6 

0.5 

2.7 

O.S 

4.6 

0.1 

2.2 

1  .0 

1.0 

1.6 

Vegetables 
(Fresh  or  Canned) 


Asparagus 

Asparagus  tips 

Brussels  sprouts 

Cabbage 

Cauliflower 

Celery 

Cucumbers 

Egg  plant 

Endive 

Greens  from  beets 

Kohlrabi 

Leeks 

Lettuce 

Pickles,  sour  or  dill 

Pumpkin 

Radishes 

Rhubarb 

Sauerkraut 

Sorrel 

Spinach 

String  beans 

Swiss  chard 

Tomatoes 

Water  cress 

Wax  beans 


THE  ACCESSORY  DIET  OF  FOODS  RICH  IN  CARBOHYDRATES 

If  the  patient's  urine  continues  to  be  sugar  free  on  a  "carbohydrate-free"  diet  of 
sufficient  caloric  value  (1500  to  1750  calories),  carbohydrate-containing  foods  may  be 
added  and  the  carbohydrate  tolerance  of  the  patient  be  determined.  In  those  cases 
able  to  utilize  a  considerable  amount  of  starch,  the  accessory  diet  may  be  varied  from 
day  to  day,  and  use  may  be  made  of  the  following  table,  which  gives  the  carbohydrate 
equivalent  of  one  slice  (1  ounce  or  30  grams)  of  white  bread,  containing  approximately 
15  grams  of  starch. 


28 


THE  ACCESSORY  DIET  OF  FOODS  RICH  IN  CARBOHYDRATES 

EACH   PORTION    CONTAINS   APPROXIMATELY    15    GRAMS    OP    CARBOHYDRATES 


Foods  Household 

Measure  Gm. 

Uncooked  FLoiirs,  etc.: 

Barley 1      h.  tbsp.  21 

Buckwheat 1      h.  tbsp.  19 

Cornmeal 1      h.  tbsp.  20 

Farina 1      h.  tbsp.  20 

Hominy 1      h.  tbsp.  18 

Macaroni 1      h.  tbsp.  20 

Noodles - IJj  K.  tbsp.  20 

Oatmeal 1      h.  tbsp.  22 

Rice 1      h.  tbsp.  18 

Rye  flour 1      h.  tbsp.  18 

Spaghetti 1)4  h.  tbsp.  20 

Vermicelli 1%  h.  tbsp.  21 

Wheat  flour 1      h.  tbsp.  20 

Bread  and  Crackers: 

Bread 1      slice.  30 

Breakfast  biscuit   (Huntley    & 

Palmer) 3  18 

Cornbread 1      slice.  32 

Roll  (Vienna) K  25 

Uneeda  Biscuit 3  18 

Zwieback 1)4  20 

Cooked  Cereals: 

"Force" 5      h.  tbsp.  18 

Farina 2)4  h.  tbsp.  125 

Grapenuts 1)4  h.  tbsp.  20 

Hominy IK  h.  tbsp.  90 

Macaroni 2      h.  tbsp.  100 

Oatmeal 2)4  h.  tbsp.  130 

Rice IK  h.  tbsp.  60 

Shredded  wheat  biscuit M  22 

Cooked  Vegetables: 

Artichokes 1      medium.  320 

Beans  (baked — canned) 2      h.  tbsp.  75 

Beans,  lima 1J^  h.  tbsp.  50 

Beets 6      h.  tbsp.  2Q0 

Carrots 13      h.  tbsp.  440 

Okra 4      h.  tbsp.  200 

Onions 3  300 

Parsnips 4      slices.  120 

Peas,  green 3      h.  tbsp.  100 

Potato  (baked) )4  medium.  60 

Potato  (boiled)  )4  medium.  70 

Potato  (mashed) .--, 1J£  h.  tbsp.  80 

Potato,  sweet  (boiled) J£  medium.  35 

Squash 2      h.  tbsp.  100 

Turnips 3      h.  tbsp.  210 


Foods 

Fruits: 

Apple 

Apricots 

Banana  (without  skin) . 
Cherries 


Gn 


1  medium.     120 

2  large.  120 
}£  medium.      75 

90 


Currants 5      h.  tbsp.  120 

Grapefruit y2  small  150 

Huckleberries 3J^h  tbsp.  90 

Lemons 2      medium.  210 

Muskmelon y,  300 

Nectarine 1  100 

Olives,  green 20  180 

Orange K  large.  150 

Peaches iy  medium.  150 

Pear 1      small.  100 

Pineapple 3      slices.  150 

Plums 2      medium.  75 

Raspberries iy  h.  tbsp.  120 

Strawberries 8      h.  tbsp.  200 

Watermelon Large  slice.  300 

Dried  Fruits: 

Apples 3      small.  22 

Apricots 3      large.  24 

Currants \y2  tbsp.  20 

Dates 3  19 

Figs 1      large.  12 

Prunes 2      large.  24 

Raisins 10      large.  23 

Milk  and  Cream: 

Buttermilk \y  tumbler.  300 

Cream,  16  per  cent 1)4  tumbler.  300 

Cream,  40  per  cent \y  tumbler.  300 

Koumiss \y2  tumbler.  300 

Whole  milk IK  tumbler.  300 

Nuts: 

Almonds 60  90 

Brazil 30  180 

Chestnuts  (roasted) 15  40 

Cocoanut 1  slice  (3X2  in.)  50 

Filberts 100  100 

Peanuts : 40  80 

Pecans 35  110 

Pistachio 190  95 

Walnuts 30  125 


Paul  B.  Hoeber,  67-69  East  59th  Street,  New  York. 


COLUMBIA  UNIVERSITY  LIBRARIES 


Mosenthal 

Diabetes  mellitus. 


RC660 

M852 
1921 


